Research On The Effect Of Diet Management In The Health Management Model Of Elderly Type 2 Diabetes Patients With Hypertension Based On Peplau’s Interpersonal Relationship Theory

Objective: To explore the metabolism level,self-management ability,medical coping style of elderly type 2 diabetes patients with hypertension through current survey.To construct a health management model based on Peplau’s interpersonal relationship theory,and to evaluate the effect of diet management,so as to provide reference for clinical management.Methods: 1.In the first phase of the investigation study,232 elderly type 2diabetes patients with hypertension in a class III hospital in Guangxi were investigated by general information questionnaire,medical coping modes questionnaire,and the summary of diabetes self-care activities measure from October 2021 to March 2022 to explore their health status and medical coping style,Single factor analysis and multiple linear stepwise regression were used to analyze the influencing factors of medical coping style.2.In the second phase,through current investigation and literature analysis,the first draft of health management model for elderly type 2 diabetes patients with hypertension was drawn up.The final plan was determined through two rounds of Delphi expert correspondence and analytic hierarchy process.3.The third phase was to explore the effect of diet management based on Peplau’s interpersonal relationship theory in elderly type 2 diabetes patients with hypertension.From June to August 2022,the elderly type 2 diabetes patients with hypertension who were admitted to in a class III hospital in Guangxi were selected as the research objects.According to the inclusion and exclusion criteria,90 patients were included.The computer was randomly divided into an observation group and a control group,with 45 patients in each group.To avoid mutual influence between the two groups of patients,they were assigned to different wards before the implementation of the intervention program.The control group was given routine diet education,while the observation group was given diet management based on Peplau’s interpersonal relationship theory.The data were collected before the intervention,3 months after the intervention,and 6 months after the intervention.The diet management ability,medical decision-making participation satisfaction,and related metabolic indicators of the two groups of patients with diabetes were compared..Results: 1.In the first phase,a total of 232 questionnaires were distributed and 228 valid questionnaires were recovered,the effective recovery rate of98.28%.General data shows that the metabolic level,self-management ability and medical coping style of elderly type 2 diabetes patients with hypertension need to be improved.Compared with the norm,the patients’ medical coping style has a lower score in the face dimension than the norm,and a higher score in the yield dimension than the norm,with a statistically significant difference(P<0.05).Single factor analysis and Multiple linear stepwise regression showed that DMC,place of residence,living conditions,UA and diabetes course had an impact on the face dimensions(P<0.05);DMC,place of residence and Hb A1 c had influence on avoidance dimension(P<0.05);DMC and living conditions have influence on yield dimension(P<0.05).2.In the second phase,computer search of chinese and foreign language databases and websites eventually included 18 documents(9 guides,4 expert consensus and 5 systematic evaluation).A total of 21 experts participated in two rounds of Delphi correspondence,and the results showed that the experts’ positive coefficients were 87.50% and 100%,the experts’ authority coefficients were0.874 and 0.879,the Kendall harmony coefficients were 0.221 and 0.378(P<0.01).Finally,the health management model of elderly type 2 diabetes patients with hypertension was determined based on Peplau’s interpersonal relationship theory,with 5 primary indicators,15 secondary indicators and 53 tertiary indicators.3.In the third phase,at the intervention stage,85 cases completed the study,with the overall effective rate of 94.44%(2 cases in the observation group and 3 cases in the control group).The results of repeated measurement analysis of variance showed that the decrease trend of Hb A1 c,FPG,BMI,SBP,DBP,Cr,UA levels in the observation group was better than that in the control group(P<0.05);the increasing trend of diabetes diet management ability and medical decision-making participation satisfaction score in the observation group was better than that in the control group(P<0.05).Conclusions: 1.The metabolism level,self-management ability,medical coping style of elderly type 2 diabetes patients with hypertension needs to be improved.At present,their medical coping style is mainly coping style,but the scores of avoidance dimension and yield dimension are still high.Medical staff should develop targeted measures according to specific influencing factors to improve the health outcomes of patients.2.The health management model for elderly type 2 diabetes patients with hypertension constructed in this study includes 5 first level indicators,15 second level indicators and 53 third level indicators,which is scientific and reliable and can provide reference for clinical management.3.The diet management based on Peplau’s interpersonal relationship theory can significantly improve the diet self-management ability and medical decision-making participation satisfaction of patients,which is of positive significance for improving the health status.